Clinical practice guidelines for the in vitro preservation and repair of severed limbs (2025 edition)

Replantation of amputated limbs is the most effective treatment for severe limb injuries, and allogeneic limb transplantation is also one of the potentially most effective methods to address limb amputation injuries in the future. The preservation and repair of severed limbs outside the body is a key factor in improving the success rate of limb replantation and transplantation. Currently, the techniques for preserving and repairing severed limbs outside the body include static refrigeration preservation technology, immersion in cryoprotective solution technology, deep cryogenic freezing technology, mechanical perfusion technology, temporary vascular shunt technology, autologous ectopic grafting technology, and experimental-stage xenogeneic cross-circulation technology. By optimizing key parameters such as temperature, pressure, and preservation solution, these techniques can extend the preservation time of the limbs and increase the success rate of replantation. Traditional techniques have a short preservation time and cannot meet clinical needs. Emerging technologies are in the ascendant and are subject to different opinions. National Clinical Research Center for Orthopedics Sports Medicine & Rehabilitation, the Microsurgery Branch of Chinese Medical Association and the Microsurgery Branch of Beijing Orthopedic Association, based on current evidence-based medical evidence, have formulated the "Clinical practice guidelines for the in vitro preservation and repair of severed limbs (2025 edition)". This guideline systematically evaluates a series of literature and related evidence-based medical research evidence published domestically and internationally in the field of organ preservation in recent years, and adds evidence-based medical research data based on the Chinese population, with the aim of further standardizing the relevant techniques for ex vivo preservation of amputated limbs in China, for industry reference.

离断肢体体外保存修复是提高肢体再植和移植成功的关键因素。目前离断肢体体外保存修复技术包括静态冷藏保存技术、低温保存液浸泡技术、深低温冷冻技术、机械灌注技术、临时血管转流技术、自体异位寄养技术和处于实验阶段的异种交叉循环等，通过优化温度、压力、保存液等关键参数延长肢体保存时间并提高再植成功率。传统技术保存时间短，不能满足临床需要，新兴技术方兴未艾，见仁见智。为此中华医学会显微外科分会、北京医学会显微外科分会组织专家基于当前的循证医学证据，制订了《离断肢体体外保存修复临床实践指南（2025版）》。本指南系统评价了国内外近年来发表的器官保存领域系列文献和相关循证医学研究证据，增加了基于国人的循证医学研究数据，旨在进一步规范我国离断肢体体外保存的相关技术，供业界参考。.